<form class="layui-form" lay-filter="tpl_pkxx{$pkxx_id}" action="{:url('pikuanxinxi/saveData')}">
	<input type="hidden" name="pkxx_id" class="layui-input" />
	<div class="layui-form-item">
		<label class="layui-form-label">付款单位</label>
		<div class="layui-input-inline">
			<input type="text" name="fkdw" lay-verify="required" placeholder="请输入付款单位" autocomplete="off" class="layui-input">
		</div>
	</div>
	<div class="layui-form-item">
		<label class="layui-form-label">地址</label>
		<div class="layui-input-inline">
			<input type="text" name="address" placeholder="请输入地址" autocomplete="off" class="layui-input">
		</div>
	</div>
	<div class="layui-form-item">
		<label class="layui-form-label">手机号</label>
		<div class="layui-input-inline">
			<input type="text" name="phone" placeholder="请输入手机号" autocomplete="off" class="layui-input">
		</div>
	</div>
	<div class="layui-form-item">
		<label class="layui-form-label">销项票</label>
		<div class="layui-input-inline">
			<input type="text" name="xxp" placeholder="请输入销项票" autocomplete="off" class="layui-input">
		</div>
	</div>
	<div class="layui-form-item">
		<div class="layui-input-block">
			<button type="button" class="layui-btn layui-btn-normal" lay-submit lay-filter="submit_pikuanxinxi">保存数据</button>
			<button type="reset" class="layui-btn layui-btn-primary">重置</button>
		</div>
	</div>
</form>
<script>
	// 赋值
	var pkxx_id = "{$pkxx_id}";
	var pikuanxinxi_form_value = {$data};
</script>
<script src="/static/js/pikuanxinxi/tpl.js" type="text/javascript" charset="utf-8"></script>
